Discussion on today's 1:00 news

[HappyHacker]

I know a retired senior NHS consultant, he took early retirement as he felt he was being forced to perform unnecessary operations on patients in order to meet waiting time targets. He believed he was committing assault on the patients. He took early retirement and this coupled with the politics of the NHS made him unwilling to continue.

I know of a senior consultant (another one) who joined new hospital. He went to the Chief Executive's office and asked for an appointment to see the CE. The CE's secretary said yes and organised an appointment for Wednesday. On Tuesday the consultant got a call saying the CE could not make Wednesday and his next available appointment was three months away. Three months later the consultant turns up to see the CE. In the office are a few people and the CE introduces himself and the others: Head of legal, Head of Nursing, Personnel Director, Head of Publicity, head of strategy, and a couple of others who's titles cannot remember. The CE then said "well Mr xx how can we help you" to which the consultant said "Thank you for getting all the team together, I just wanted to meet you so that if a met you in a corridor would know who you are. Now I know all the management team". From another source he learnt that in the intervening three months the management team had had endless meeting to discuss what the consultant was going to ask/complain about and they had discussed the patients who he may want to complain about and what they would jointly give as answers. Why the hospital did not have an induction programme for the senior medical staff that would have included meeting the management is unclear and why they could not have simply asked him what he wanted to talk about?

A the same hospital a consultant was suspended after one of his patients died of a pre-existing condition that was outside the consultants speciality. After three external enquires into the consultants treatment of the patient, all of which said the consultant had done everything possible, the consultant was still suspended by the hospital. Presumably to cover up the lack of care provided by the medical team who should have been treating the patients problems. A few years later the consultant resigned, while still suspended, as he did not feel competent to operate any more.

With so many example of senior management taking redundancy or payments to leave following mismanagement, who then get better paid jobs in other trusts it is no wonder that there are problems. While more money would help in a well managed organisation I do not think it is the main answer for the NHS.

 

[Jacob]

Elitist....as in the elite sending their children to private schools, perhaps ? Like Diane Abbot, for instance :-"

She's been retired due to ill health. But yes I agree - sending your kids to private schools should be a sackable offence for a Labour politician.

 

[Farmer Giles]

My neighbour is a recently retired pediatrician, he will regale you with many stories about funding issues and also the way the NHS could improve. The truth is that each hospital or group of hospitals are not representative of the whole of the NHS and decisions like opening up the NHS to the market hasn't achieved efficiencies they promised, this is an informative read

We are not going to solve it here but selling off the assets for a one off capital injection at a cost of 10 Billion to the tax payer and farming out services to third parties is not going to solve them either. In my experience in business outsourcing = mediocrity + higher costs. For every bad story about the NHS I hear many good ones, but they are usually repressed as they don't promote the agenda. My father has had fantastic care.

 

[Phil Pascoe]

A few more for sacking? Thornberry and Milne sent their children to selective schools (as did Bliar before them), and Sham Chakrabarti sends hers to a private one. Even the supposed arch socialist prat Galloway had his privately educated. But they're different, you see. Special. Their needs are not the same as my children or yours. The shadow education minister didn't even take A levels. You couldn't make it up.

FG - some things are better outsourced - why would anyone presume e.g. that a hospital manager could run an efficient large laundry?

 

[RogerS]

Segueing ever so slightly sidewards, I predict that the turnout for tomorrow's election will be one of the lowest for years.

 

[Farmer Giles]

A few more for sacking? Thornberry and Milne sent their children to selective schools (as did Bliar before them), and Sham Chakrabarti sends hers to a private one. Even the supposed arch socialist prat Galloway had his privately educated. But they're different, you see. Special. Their needs are not the same as my children or yours. The shadow education minister didn't even take A levels. You couldn't make it up.

FG - some things are better outsourced - why would anyone presume e.g. that a hospital manager could run an efficient large laundry?

On schooling, if my local comprehensive has been underfunded so the buildings are damp, crowded and not attracting good teachers, like it is, then I will seek better schooling for my kids, but I would prefer to use the local comprehensive. As a parent I will look after my kids interest first, it doesn't mean I don't support a decent level playing field for all kids, we need the brains of all the gene pool in our future, not just the genes of people who can afford to send their kids to decent schools.

Totally agree on the laundry, but not front line nursing staff, all you get is more cost, less money spent on care as you are paying for one or sometimes two profit margins, less training, less accountability and more complex management.

 

[RobinBHM]

It seems that France and Germany have good models for healthcare.

3 things stick out to me:
-healthcare is a ring fenced tax
-flexible boundaries between state and private systems
-more is spent per %gdp

Germany of course has a fantastic economy with a surplus.
France and Germany have highly regulated employment and taxation systems which somewhat stifle investment from foreign companies.
Germany has almost no waiting times for healthcare

extract from article in the Daily Mail (yes I know! but still quite a good article)

The superior performance of health services in France and Germany is not simply the result of greater public investment but owes a great deal to the evolution of a hybrid system of funding medical care.
Although Britain spends less on health than its European neighbours, the set up of health care systems in France and Germany is unencumbered by the division between private and public sector that exists in the UK.
While UK health care is firmly split into NHS and private sector care --with one being paid for by the state and the latter being funded from people's savings or medical insurance - the European model keeps the boundaries flexible.
As well as spending more on health, both France and Germany impose ring-fenced health taxes, while encouraging people to take out 'top-up' private medical insurance.
A patient is free to choose to be treated in either a public sector or private hospital, with the service being paid for either through taxes, or privately, or a mixture of both.


http://www.dailymail.co.uk/health/artic ... z4jJA5tv7h

 

[Jacob]

.......
On schooling, if my local comprehensive has been underfunded so the buildings are damp, crowded and not attracting good teachers, like it is, then I will seek better schooling for my kids, but I would prefer to use the local comprehensive. As a parent I will look after my kids interest first, it doesn't mean I don't support a decent level playing field for all kids, we need the brains of all the gene pool in our future, not just the genes of people who can afford to send their kids to decent schools......

Absolutely.
We see the worst outcome of the private education system (the fast tracking into positions of power and influence), in parliament - people like Boris Johnson who are clearly stupid, talentless and incompetent.

 

[Phil Pascoe]

Back off political point scoring - I noticed in the eight weeks I've spent in hospital in the last six months that there was scarcely a day or more often a night that someone didn't turn up for work and an agency worker was called in. Surely it's not beyond the wit of the management to overstaff one or two wards so there would be staff to draw on, instead of paying through the nose for agency workers?

 

[Phil Pascoe]

Jacob, I'm sure Boris speaks highly of you.
Mayor of London and Foreign Minister ... not doing bad for a dimwit, is he? :lol:

 

[Jacob]

Jacob, I'm sure Boris speaks highly of you.
Mayor of London and Foreign Minister ... not doing bad for a dimwit, is he? :lol:

My whole point is that privileged background and private education helps get dimwits like him into positions of power and influence well beyond their natural ability.
Not bad for the privilege system!

 

[bugbear]

Jacob, I'm sure Boris speaks highly of you.
Mayor of London and Foreign Minister ... not doing bad for a dimwit, is he? :lol:

I don't think dimwits get scholarships to Oxbridge...

The "good old, thick old Boris" thing is a very effective act that keeps fooling people.

BugBear

 

[RobinBHM]

Boris may come across as bumbling but he is very intelligent and is very good in interviews.

Whether one agrees with his policies is another thing!

We see the worst outcome of the private education system (the fast tracking into positions of power and influence)

-like Tony Blair for example

or Angela Rayner sending her children to selective school

 

[Farmer Giles]

BJ is certainly academically bright, but it takes more than that. His blustering covers his shortcomings in common sense and his duplicitous nature, his only allegiance is to self aggrandisement he is certainly not bothered about making the right decisions for us.

 

[Jacob]

Boris may come across as bumbling but he is very intelligent and is very good in interviews. .....

I don't think he is intelligent. That public school sharpness of wit often passes incorrectly for intelligence. He is good in interviews sometimes. He has been appallingly awful in interviews too. Overall his contribution to the public good is severely negative.
Many of these public school whizz kids end up in politics, finance, business management, because they don't have the skills to do a proper job but they do have privileged access.

BJ is certainly academically bright, ....

He's had every educational privilege possible at every point in his life so he could hardly fail. But he's not that bright at all. His book on the Romans is a good read but it's childish comedy compared to serious equivalents like Mary Beard's book.
He writes like a smart-aleck public school boy who had done his homework, can spell and has a bit of a sense of humour. But not academically bright.

He's a really good example of what wealth, confidence and privilege can do for you if you have little natural ability or intelligence.

He is also the best example going of how bad the public school system is for the rest of us - we end up with idiots controlling our lives.

 

[Phil Pascoe]

:idea: get back to the NHS before the thread gets locked. It was quite sensible and interesting before it degenerated once again to politics.

 

[Phil Pascoe]

I asked why I had a 120 mile round trip and a waste of a day and an uncomfortable ride for me and a day and a day's holiday for my wife to see a specialist consultant, nurse and physiotherapist, and what they were going to do that couldn't be done locally and I got a reply stating that it might save time in the future (whose, she didn't say) and that they had had very good reports of their services. They were very concerned with customer satisfaction, and strove to improve services. Unfortunately this was sent from an email address that didn't accept replies. Some service. Some concern.

 

[Farmer Giles]

I asked why I had a 120 mile round trip and a waste of a day and an uncomfortable ride for me and a day and a day's holiday for my wife to see a specialist consultant, nurse and physiotherapist, and what they were going to do that couldn't be done locally and I got a reply stating that it might save time in the future (whose, she didn't say) and that they had had very good reports of their services. They were very concerned with customer satisfaction, and strove to improve services. Unfortunately this was sent from an email address that didn't accept replies. Some service. Some concern.

"That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital." Noam Chomsky

 

[Jacob]

I asked why I had a 120 mile round trip and a waste of a day and an uncomfortable ride for me and a day and a day's holiday for my wife to see a specialist consultant, nurse and physiotherapist, and what they were going to do that couldn't be done locally and I got a reply stating that it might save time in the future (whose, she didn't say) and that they had had very good reports of their services. They were very concerned with customer satisfaction, and strove to improve services. Unfortunately this was sent from an email address that didn't accept replies. Some service. Some concern.

Well yes and many complain of long waits for an appointment followed by long waits in the waiting room. But arguably this makes for efficiency - it guarantees that the service is used to the full and there will be no waiting for no-shows. They aren't wasting any of their time , instead they are wasting yours!
It's been improving recently for me at least - I have to turn up for a sequence of eye tests every six months but get through the system fairly quickly. It used to be really slow

 

[graduate_owner]

Well I am glad I started his thread, the responses have been interesting and informative. I wasn't suggesting just throwing more and more money at the NHS, although I suspect most people would agree that it is under funded. The issues are indeed complex, and bed blocking is a major problem. However I just could not agree with the consultant's comments that we don't need more beds when there are such problems with waiting lists. I think we definitely need more beds, whether they are created by re-opening mothballed wards or by (somehow) solving the bed blocking problem, or indeed by whatever other means may be found. It may sound unrealistic, even simplistic to make such a statement, but I feel it is all too easy for the status quo to be allowed to continue without any authority wanting to take responsibility for formulating a solution. If solving the bed blocking problem can be done by local authorities re-opening existing care facilities, building new, or taking over existing privately run ones or whatever then perhaps that is where additional funds should be directed. The effect on waiting times would not only benefit patients, but also benefit the NHS budget in that there would be less money wasted buying in private health services in order to comply with impossible targets.
Whichever political party prepared to take on this challenge would surely be on a vote winner. Just thought I would make that comment seeing as there is a general election tomorrow. I shall vote, but I have never been less inclined to do so.

K